THE KENTUCKY SOCIETY OF RADIOLOGIC TECHNOLOGISTS INC.,
CANDIDATE INFORMATION FORM
PERSONAL DATA
Name: JessicaLynnStafford
(first)(middle)(last)
2024 Howard Ln
Street
Mount SterlingKY40353
CityStateZip Code
____________
Home Phonee-mail address
Baptist Health Lexington
Employer Name
1740 Nicholasville Rd
Employer Address
LexingtonKY40503
City StateZip Code
859-260-6437
Employer Phone Number
I PREFER TO RECEIVE ALL KSRT,INC. CORRESPONDENCE/COMMUNICATION AT:
(check one):
HOME ___X___ BUSINESS ______
ASRT IDENTIFICATION #: 539152
ARRT REGISTRATION DATE: 4/2015 ARRT REGISTRATION #:437899
ARRT REGISTRY IN (place an X next to the discipline(s) you are certified in):
Radiography (R) __X_Nuclear Medicine ( N) _____
Sonography (S) _____Mammography (M) _____
Quality Management (QM) _____Magnetic Resonance (MR) _X__
Cardiovascular Tech (CVT)_____Bone Densitometry (BD) _____
Cardac-Interventional (CI) _____Vascular Interventional (VI) _____
Computed Tomography (CT) ___X___
ACADEMIC INFORMATION (list all college, university, and hospital programs attended)
Morehead State University, Morehead, KY2008AAS
______
NameCity, STDate Graduated Degree
Morehead State University, Morehead, KY2009BS
______
NameCity, STDate Graduated Degree
______
NameCity, STDate Graduated Degree
______
NameCity, STDate Graduated Degree
______
NameCity, STDate Graduated Degree
****Please enclose photo, preferably black and white****
PROFESSIONAL SOCIETY HISTORY (Detail all office, appointment, and committee history - including date(s) of service. Also list any awards received.)
ASRT –
-House of Delegates (ASRT governing body/Congress)
2012
-House of Delegates (ASRT governing body/Congress)
2013
-ASRT RT in DC:
I represented the state of Kentucky. RT in DC is a national lobbying effort by the American Society of Radiologic Technologists to obtain minimum educational standards imaging professionals.
Washington D.C.
2010, 2011, 2012, 2013
ASRT Committee on RT Advocacy-Sub Committee
2014-2015
KSRT, Inc.
2014 Co-Chair Annual Fall meeting, Kentucky Society of Radiologic Technologist
2013-2014Board Chair, Kentucky Society of Radiologic Technologists
2014Co-Chair Annual Spring Meeting, Kentucky Society of Radiologic Technologists
2013Co-Chair Annual Meeting, Kentucky Society of Radiologic Technologists
2012-2013President, Kentucky Society of Radiologic Technologists
2012Co-chair Annual Meeting, Kentucky Society of Radiologic qTechnologists
2011-2012 President-Elect, Kentucky Society of Radiologic Technologists
2011Student Seminar Co-Chair, Kentucky Society of Radiologic Technologists
2010-2011Vice President, Kentucky Society of Radiologic Technologists
2010Student Seminar Co-Chair, Kentucky Society of Radiologic Technologists
2009-2010Member At Large, Kentucky Society of Radiologic Technologists
Committees:Election
Annual Meeting
Membership
LOCAL/DISTRICT:
I am a candidate for the office of: ______President-Elect______
POSITION STATEMENT: (Why you are a candidate for this office?, in 100 words
or less.) Statement must be typed. Statement will be published as printed in its entirety.
I, Jessica Stafford, do hereby certify that the informationprovided by me in this document is true and accurate.
DATE: 8/1/14